Early motor repertoire and neurodevelopment at 2 years in infants born extremely preterm or extremely-low-birthweight.

AIM

To determine the relationship between early motor repertoire and 2-year neurodevelopment in infants born extremely preterm (<28 weeks' gestation) or extremely-low-birthweight (ELBW) (<1000g).

METHOD

This was a geographical prospective cohort of 139 infants born extremely preterm/ELBW (mean gestational age 26.7 weeks, standard deviation [SD] 2.0, 68/139 [49%] male), with parent-recorded videos suitable for scoring the General Movements Assessment (GMA). Motor repertoire was assessed using the Motor Optimality Score-Revised (MOS-R), with and without the fidgety movement subsection, and the GMA alone at 12 to 13  weeks corrected age and 14 to 15  weeks corrected age. At 2 years corrected age, impaired development was defined as Bayley Scales of Infant and Toddler Development, Third Edition motor and cognitive development scores 1SD or less relative to controls born at term; paediatricians diagnosed cerebral palsy (CP).

RESULTS

Greater MOS-R scores at 14 to 15  weeks corrected age were associated with lower odds of CP (odds ratio [OR] per 1-point increase=0.83, 95% confidence interval [CI]=0.71-0.99), and motor (OR=0.93, 95% CI=0.87-0.99), or cognitive impairment (OR=0.94, 95% CI=0.88-0.99). Absent/abnormal GMA at 14 to 15 weeks was associated with CP and motor delay. There was little evidence that MOS-R scores at 12 to 13 weeks were associated with neurodevelopmental outcomes at 2 years.

INTERPRETATION

Poorer MOS-R scores and absent/abnormal GMA, scored from parent-recorded videos at 14 to 15  weeks gestational age, are associated with CP and developmental impairment in 2-year-old infants born extremely preterm/ELBW.